The invention is generally directed to the use of resorbable suspension devices in connection with plastic surgery and related surgical procedures and in particular to a new resorbable appliance and the use of a resorbable appliance for use in connection with endoscopic brow lift surgery and similar procedures.
In the past, various approaches have been used to shift and hold soft tissue in place during the course of plastic surgery modification of a patient's anatomy. A brow lift procedure is used to eliminate the generally horizontal lines on a patient's forehead at rest by elevating the top of the patient's brow from the skull and suspending the brow in a superior position for a sufficient period of time so that the soft tissue of the scalp and connective tissue knits in place, leaving the patient with an unlined brow. In the past, invasive surgery using standard surgical cutting tools and open surgical sites using a scalpel have resulted in large entry wounds which tend to create large scars which must be hidden, where possible, under the patient's hairline. However, in many cases, the patient's hairline is inadequate as a means for camouflaging the surgical incision and as a result, these operations were generally not favored due to the complications as well as the large scars which would result.
As the state of the art of surgery improved, it became possible to conduct the brow lift surgery with the use of an endoscope which allows the physician to make a small incision and then extend the tools to be utilized through the small slit and view the work area with the endoscope and complete the surgery without the need for a large surgical incision. The endoscope is similar to the arthroscope utilized in connection with surgery conducted on the knees, shoulders and elbows. In the traditional surgery the soft tissue of the scalp above the brow is held in place by an outside support. Recently, surgical pins or posts have been put in place in the skull to anchor the soft tissue in place. After a period of time following the completion of the healing process, during which the soft tissue is firmly bonded into its new location, the surgeon must reenter the site, remove the pin or post and then reclose the incision. This procedure increases the risk of infection as a substantial risk of infection exists each time an incision is made. In addition, the volume occupied by the removed pin creates an internal space susceptible to collection of fluids and other undesired results. Furthermore, the patient must return and must again suffer the pain or at least discomfort of further incision including the risk of anesthesia whether local or general as well as the need to have further bandages. In some cases it is possible to permanently leave the metal posts or pins in the wearer's skull. However, for purely cosmetic procedures such as the brow lift, most patients are reluctant to have metal pins or posts inserted into their skull, either to remain forever or to be removed at some later date.
As an improvement to the basic brow lift surgery conducted with traditional surgical techniques, the applicant herein has developed a system for endoscopic brow lifts incorporating a portion of a surgical pin cut to the appropriate lengths. Each of these pins is inserted through incisions made through the scalp in connection with the endoscopic procedure to suspend parts of the patient's scalp. Finally, after the tissue has healed in place and the edema has gone down, another endoscopic procedure is required to remove the pins. Again, the risks inherent in reentry are present as well as the discomfort, inconvenience and additional cost to the patient for a second, albeit smaller, surgical procedure.
Accordingly, there is the need for an improved surgical appliance for supporting soft tissue in a specified fixed location in which the surgeon would only need to once invasively enter the patient's body. It is desired to have the material utilized to suspend the soft tissue or scalp be formed of a material which has the appropriate structural requirements necessary to retain the soft tissue under tension in place and that those characteristics be maintained for a sufficient time to allow complete healing. Thereafter the appliance should be absorbed by the body naturally over a period of time so that no further surgical procedure is necessary.